P1330: IMPACT OF COVID-19 IN HSCT ACTIVITY. A SURVEY FROM THE INFECTIOUS DISEASES WORKING PARTY (IDWP) OF EBMT
Authors: R. De La Camara, Z. Szmit, P. Ljungman, N. Knelange, L. Wendel, G. Tridello, K. Kalwak
Journal: HemaSphere (2022)

Background: The SARS-CoV-2 pandemic has impacted nearly all the aspects of HCT. One of those has been historical: the decrease for the first time in 30 years in the whole transplant activity (Passweg J. BMT 2022) Aims: To analyse the impact of the pandemic on HCT activity in 2020 compared to pre-pandemic 2019 Methods: In April 2021, a survey was sent to all EBMT centres to collect the HCT activity, reporting the number of transplant patients by month for 2020 and 2019 Results: A total of 168 centres participated: 136 adult and 75 paediatric centres (43 did both) 1.- HCT activity in adults 1.1 Global (allo & auto): a marked decrease in activity from March-May, with the biggest drop in April 2020 (-40.6%) (Fig 1) 1.2 Allogeneic: a marked decrease in activity from March-May 2020, the biggest drop in April (-39%), and a moderate total decrease (-6.1%). -Matched related donor (MRD) (1,201 vs 1,434): a marked decrease in activity from April-July, the biggest drop in April (-46%), and a marked total 2020 decrease (-16%) - Mismatched related/haploidentical donor (MMRD) (1,005 vs 869): no decrease in activity, with a final 15% total increase. - Unrelated donors (URD) with PB/BM (2,348 vs 2,558): a marked decrease in activity from March-May, the biggest drop in April (-46%), and a moderate total decrease (-8%). -URD Cords (57 vs 50): no decrease in activity. However, too few cases 1.3 Autos: a marked decrease in activity from March-May, the biggest drop in April (-42%), but a moderate total decrease (-7%) 1.4 Non-malignant diseases (47% auto and 53% allo-HCT): a marked total decrease, higher in allo-HCT (-19.7%) than in auto-HCT (-5.6%) 2.- HCT activity in children 2.1 Global (allo & auto): a discrete increase in the activity in nearly all months, with a 5.2% total increase. 2.2 Allogeneic -Total: marked decrease in activity in April (-29.3%), but nearly identical total activity. -MRD (532 vs 611): a marked decrease in activity from March-May, with the biggest drop in April (-56%), and a marked total decrease (-13%). -URD PB/BM (631 vs 651): a marked decrease in activity for URD from April-May, with the biggest drop in April (-46%), but a mild total decrease (-3%). -MMRD (446 vs 373): an increase in activity in all months, with a final 19.5% increase. -URD Cords (69 vs 37): an increase in activity in nearly all months, however few cases. 2.3 Autologous HCT: an increase in activity in nearly all months, with a 21% total increase 2.4 Non-malignant diseases (4% auto and 96% allo-HCT): a marked total decrease of 15.9%, due to a marked decrease in allo-HCT (-18.2%) not compensated by a 64% increase in auto-HCT Image:Summary/Conclusion: The SARS-CoV-2 pandemic had a significant impact on HCT activity in 2020 compared to 2019, with substantial differences between adults and children. Globally there was a mild decrease in HCT activity in 2020 (-4.7%) due to a moderate decrease in adult HCTs (-6.6%) not compensated by a 5.2% increase in pediatric transplants. Non-malignant diseases had a marked decrease (-14.9%), both in adults and children In adults, a similar decrease was observed in allo and auto-HCT (-6.1% vs -7%). MRD suffered the greatest decrease (-16%), followed by URD with PB/BM (-8%). In contrast, URD Cords and MMRD showed a marked increase (+14% and +15%) In children, auto-HCT showed an unexpected marked increase (21%) with no variation in allo-HCT. MRD suffer the greatest decrease (-13%), followed by URD with PB/BM (-3%). In contrast, URD Cords and MMRD showed a marked increase (+86% and +19.5%) The increase in cords and MMRD HCT was probably due to the easier access of these donors in a pandemic situation